Deaths from all causes in a long-term follow-up study of 11583 deliberate self-harm patients

Hawton, Keith; Harriss, Linton; Zahl, Daniel Louis

doi:10.1017/s0033291705006914

Cited by 107 publications

(84 citation statements)

References 18 publications

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“…Because suicidal behavior is the single most important risk factor for completed suicide in adolescents, the identification of precursors of adolescent suicidal behavior is of great public health importance (40). This first report of precursors of suicidal behavior in a sample at familial risk helps to identify families at very high risk of having a child with suicidal behavior and frames targets for prevention and treatment.…”

Section: Discussionmentioning

confidence: 99%

Familial Pathways to Early-Onset Suicidal Behavior: Familial and Individual Antecedents of Suicidal Behavior

Melhem¹,

Brent

Ziegler³

et al. 2007

AJP

162

129

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Objective-The authors sought to identify clinical predictors of new-onset suicidal behavior in children of parents with a history of mood disorder and suicidal behavior.Method-In a prospective study of offspring of parents with mood disorders, 365 offspring (average age, 20 years) of 203 parents were followed for up to 6 years. Offspring with incident suicide attempts or emergency referrals for suicidal ideation or behavior ("incident events") were compared with offspring without such events on demographic and clinical characteristics. Multivariate analyses were conducted to examine predictors of incident events and predictors of time to incident event.Results-Offspring of probands who had made suicide attempts, compared with offspring of parents with mood disorders who had not made attempts, had a higher rate of incident suicide attempts (4.1% versus 0.6%, relative risk=6.5) as well as overall suicidal events (8.3% versus 1.9%, relative risk=4.4). Mood disorder and self-reported impulsive aggression in offspring and a history of sexual abuse and self-reported depression in parents predicted earlier time to, and greater hazard of, an incident suicidal event.Conclusions-In offspring of parents with mood disorders, precursors of early-onset suicidal behavior include mood disorder and impulsive aggression as well as parental history of suicide attempt, sexual abuse, and self-reported depression. These results suggest that efforts to prevent the familial transmission of early-onset suicidal behavior by targeting these domains could reduce the morbidity of suicidal behavior in high-risk youths.The literature on suicide demonstrates, on the basis of adoption, twin, and family studies, that suicidal behavior aggregates in families and that the familial transmission of suicidal behavior cannot be explained by the transmission of major psychiatric disorders alone (1). However, nearly all of these family genetic studies are cross-sectional, which means that little is known about the precursors of suicidal behavior that place offspring of suicidal individuals at increased risk of suicidal behavior and the causal models to explain how suicidal behavior is transmitted from parent to child.Nevertheless, the literature provides clues as to the mechanisms and precursors of familial transmission of suicidal behavior. Longitudinal community studies show that precursors of youthful suicidal behavior include depression, suicidal ideation, behavioral symptoms, child NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript maltreatment, and family history of suicidal behavior (2-4). Cross-sectional studies have shown that the familial aggregation for suicidal behavior is related to the trait of impulsive aggression. Higher levels of impulsive aggression in those who attempt or compete suicide are associated with greater family aggregation for suicidal behavior (5, 6), and higher levels of impulsive aggression in parents are associated with child suicidal behavior (7). In one cross-sectional study, the famili...

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Section: Discussionmentioning

confidence: 99%

Familial Pathways to Early-Onset Suicidal Behavior: Familial and Individual Antecedents of Suicidal Behavior

Melhem¹,

Brent

Ziegler³

et al. 2007

AJP

162

129

View full text Add to dashboard Cite

show abstract

“…In the USA, Spirito et al (1989) showed that up to 11% of adolescents who self-harm will eventually take their own life. Hawton et al (2006b) identified via the Oxford Monitoring System for Attempted Suicide a cohort of over 11 000 patients aged 15 who self-harmed. Follow-up over a mean period of 11 years found a death rate of 10.2%.…”

Section: Discussionmentioning

confidence: 99%

Self-harm in adolescents

Wood¹

2009

Adv. psychiatr. treat

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SummarySelf-harm in adolescents is common and is increasing. It can present to professionals as a symptom of major mental health disturbance or it can form part of a cultural ‘norm’. This article reviews current knowledge about self-harm in 12- to 18-year-olds. Definitions of self-harming behaviour, epidemiological and aetiological factors, risk assessment and management of self-harming in various settings are discussed in terms of pragmatic clinical approaches and evidence-based practice.

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“…Table 1. Clinical pathways identified in the literature and assessed against the criteria of Kinsman et al 15 The first five pathways [25][26][27][28][29] were developed by British National Health Service (NHS) Trusts as a result of local clinical practice guidelines. The criteria of Kinsman et al 15 Ò Ò Ò Ò Ò Designed for young people in the local area, stops at the ED but gives some post-discharge resources Nurse-led pathway 30 Ò Ò Ò Ò Ò Ò Description of care pathway to provide a 'fast track' through the ED Hunter Area model for management of selfpoisoning 18 Ò Ò Ò Ò Ò Care pathway covers all age groups but is only for self-poisoning, not other forms of deliberate self-harm or suicidality more generally A Pathways specifically for children and young people.…”

Section: Where To Next?mentioning

confidence: 99%

“…27,28 This, coupled with the increasing number of suicidality presentations in a heterogeneous group of patients and the need to encourage community-based approaches for follow-up instead of using the ED for repeat crisis presentations, highlights the importance of implementing clinical pathways for local settings as important issues in health service and public health domains.…”

mentioning

confidence: 99%

Clinical pathways for suicidality in emergency settings: a public health priority

Wilhelm

Korczak²,

Tietze

et al. 2017

Aust. Health Review

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Abstract.Rates of self-harm in Australia are increasing and constitute a concerning public health issue. Although there are standard treatment pathways for physical complaints, such as headache, abdominal pain and chest pain, in Emergency Medicine, there is no national pathway for self-harm or other psychiatric conditions that present to the emergency department. Herein we outline the difference between clinical practice guidelines and clinical pathways, discuss pathways we have identified on self-harm in Australia and overseas and discuss their applicability to the Australian context and the next steps forward in addressing this public health issue.Additional keyword: emergency department.

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Deaths from all causes in a long-term follow-up study of 11583 deliberate self-harm patients

Cited by 107 publications

References 18 publications

Familial Pathways to Early-Onset Suicidal Behavior: Familial and Individual Antecedents of Suicidal Behavior

Familial Pathways to Early-Onset Suicidal Behavior: Familial and Individual Antecedents of Suicidal Behavior

Self-harm in adolescents

Clinical pathways for suicidality in emergency settings: a public health priority

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